Thanks for your help with case 2 the patient has been diagnosed with Ehlers Danlos and will have an echo arranged to check for any cardiac problems.

You now receive a call from the local district general hospital regarding a 7 year old boy who has presented with bruises over abdomen and one on his ear. They have called the tertiary centre in line with regional policy as initial FBC and coagulation screen was normal apart from a prolonged APTT of 50 seconds. They wonder if this finding is significant?

Social services have been contacted as there is concern this may be an NAI.

The boy is otherwise well has no family history of bleeding disorders and has no bleeding history of note.

What tests would you ask for to clarify long APTT?

Would you ask them to perform further tests locally or send the child to your centre?